Background: Recently we showed that the hyperventilation test induces different blood pressure (BP) responses both in healthy subjects and patients with essential hypertension. Aim: We evaluated whether pressor responses to hyperventilation change with aging in normotensive and hypertensive subjects and whether they are related to the daytime pressor profile. Methods: Forty-three elderly normotensive subjects and 94 elderly hypertensive patients (45 with essential hypertension and 49 with secondary hypertension) underwent five minutes of forced hyperventilation and daily ambulatory BP monitoring. Results: Hyperventilation did not significantly change BP in normotensive subjects and secondary hypertensive patients, whereas it decreased (p<0.01) BP in essential hypertensive patients. Hierarchical cluster analysis based on BP responses to hyperventilation disclosed three groups of subjects in each studied population: group 1 exhibited a reduction (p<0.05) in BP (prevalent in essential hypertensives, 76 %), group 2 no change (prevalent in normotensives, 70 %, and in secondary hypertensives, 76 %), and group 3 an increase (p<0.05). Pressor daytime profiles of hypertensive patients showed significant differences according to pressor responses to hyperventilation. In group 1 patients the peak ambulatory SBP correlated (p<0.01) to the pre-hyperventilation SBP, whereas in group 3 it correlated (p<0.01) to the hyperventilation peak SBP. Group 2 did not show major daily BP fluctuations. Conclusions: 1) Aging decreases reactivity to the effects of respiratory alkalosis in elderly normotensive subjects; 2) hyperventilation induces significant pressor changes overall in essential hypertension; 3) the significant pressor responses to hyperventilation reflect the daytime pressor profiles predicting the highest daily fluctuations of BP values.

Pressor responses to hyperventilation in normotensive and hypertensive elderly subjects.

FONTANA, FIORELLA;BERNARDI, PASQUALE;
2006

Abstract

Background: Recently we showed that the hyperventilation test induces different blood pressure (BP) responses both in healthy subjects and patients with essential hypertension. Aim: We evaluated whether pressor responses to hyperventilation change with aging in normotensive and hypertensive subjects and whether they are related to the daytime pressor profile. Methods: Forty-three elderly normotensive subjects and 94 elderly hypertensive patients (45 with essential hypertension and 49 with secondary hypertension) underwent five minutes of forced hyperventilation and daily ambulatory BP monitoring. Results: Hyperventilation did not significantly change BP in normotensive subjects and secondary hypertensive patients, whereas it decreased (p<0.01) BP in essential hypertensive patients. Hierarchical cluster analysis based on BP responses to hyperventilation disclosed three groups of subjects in each studied population: group 1 exhibited a reduction (p<0.05) in BP (prevalent in essential hypertensives, 76 %), group 2 no change (prevalent in normotensives, 70 %, and in secondary hypertensives, 76 %), and group 3 an increase (p<0.05). Pressor daytime profiles of hypertensive patients showed significant differences according to pressor responses to hyperventilation. In group 1 patients the peak ambulatory SBP correlated (p<0.01) to the pre-hyperventilation SBP, whereas in group 3 it correlated (p<0.01) to the hyperventilation peak SBP. Group 2 did not show major daily BP fluctuations. Conclusions: 1) Aging decreases reactivity to the effects of respiratory alkalosis in elderly normotensive subjects; 2) hyperventilation induces significant pressor changes overall in essential hypertension; 3) the significant pressor responses to hyperventilation reflect the daytime pressor profiles predicting the highest daily fluctuations of BP values.
FONTANA F.; BERNARDI P.; LANFRANCHI G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/55057
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